Provider Demographics
NPI:1902347412
Name:HAMNER, CHELSEA LAUREN SMISEK (ITDS)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LAUREN SMISEK
Last Name:HAMNER
Suffix:
Gender:
Credentials:ITDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1757 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5446
Mailing Address - Country:US
Mailing Address - Phone:407-506-6705
Mailing Address - Fax:352-241-6361
Practice Address - Street 1:1757 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5446
Practice Address - Country:US
Practice Address - Phone:407-506-6705
Practice Address - Fax:407-988-1514
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist